Sensorineural hearing loss, menieres, otitis media, age-related hearing loss

What is sensorineural hearing loss?

Hearing loss caused by dmg to inner ear or vestibulocochlear nerve

• pt can hear sound but not understand speech

What are the causes of sensorineural hearing loss?

• congenital and hereditary factors

• presbycusis, menieres

• trauma, noise exposure, ototoxicity

What is Meniere’s disease?

Accumulation of endolymph in membranous labyrinth

What are the s/s of sudden severe attacks in Meniere’s?

• Vertigo

• n/v

• sweating

• nystagmus

What are the s/s prior to attacks in meniere’s?

• fullness in ear, ear pressure

• tinnitus

• muffled hearing

What are the s/s of drop attacks in meniere’s?

• feeling of being pulled to the ground

• feeling like they are whirling in space

What are the nursing implications for menieres?

• if vertigo occurs

  • go in dark and quiet room

  • avoid sudden movements

  • close eyes during vertigo

  • avoid fluorescent, flickering lights and TV

  • avoid swimming/high places until its under control

• give emesis basin

• place pt as fall precaution

• Monitor I+Os

What is acute otitis media?

Infection of the tympanum, ossicles, and middle ear

What is otitis media w/effusion?

inflammation of middle ear w/fluid collection in middle ear space - often follows acute otitis media

What is chronic otitis media + mastoiditis?

persistent ear infections

What are the s/s of acute otitis media?

• redness, bulging, and pain of tympanic membrane

• fever, pain, malaise

• drainage from ear, reduced hearing

What are the s/s of otitis media w/effusion?

• feeding of fullness or plugged ears

• popping in ears

• decreased hearing

What are the s/s of chronic otitis media + mastoiditis?

• purulent drainage

• inflammation, pain

• hearing loss

• nausea, dizziness

• cholesteatoma - can destroy bones

How is acute otitis media treated?

• drug therapy (oral antibiotics, ear drops)

• Surgery (myringotomy - tiny incision in ear drug to relieve pressure)

  • may place tympanostomy tube

• if of allergic origin (antihistamines, nasal corticosteroid)

How is otitis media with effusion treated?

• usually resolves on its own

• can recur

How is chronic otitis media + mastoiditis treated?

• drug therapy (antibiotics - otic and systemic)

• Evacuation of ear drainage

• Surgery

  • tympanostomy (repairs perforation or dmg to ear drum)

  • mastoidectomy (removes diseased ear cells within mastoid bone)

what is the nursing care for chronic otitis media + mastoiditis?

• educate pt:

  • change dressing/cotton ball

  • keep suture line dry

  • may have impaired hearing after surgery

what is age related hearing loss?

Calcification of ossicles causes presbycusis: diminished sound transmission

• may also cause diminished sensitivity to high-pitched sounds, impaired speech reception, and tinnitus